abortion referral

Catholic hospitals set to ban abortion
Terminations will be refused under bishops’ ethics code

Ellen Coyne, Senior Ireland Reporter
July 25 2018

Catholic hospitals could break the law and refuse to offer abortions in all circumstances, a “code of ethics” drafted by the Irish Catholic Bishops suggests. Guidelines for up to 20 main hospitals connected with religious orders include a ban on most assisted reproduction procedures. The few allowed are not to be given to unmarried women or LGBT couples.

The Code of Ethical Standards for Healthcare, which sets out what can be expected from Catholic healthcare services, bans contraception; gender reassignment surgery for transgender people, crisis pregnancy counselling with information on abortion and counselling for families going through a fatal foetal abnormality diagnosis that lists termination as an option.

Government expects to design ‘opt-in’ GP system for abortion
Doctors not participating will be obliged to refer patients elsewhere for treatment

June 12, 2018
Sarah Bardon Political Reporter

The Government is expected to design an opt-in system for medical professionals willing to provide abortion services and allow doctors conscientiously object to providing the care.

The legislation to regulate the termination of pregnancy, in line with the decision made in last month’s referendum to repeal the Eighth Amendment, is being considered by the Attorney General Séamus Woulfe’s office.

GPs group calls on Harris to ensure doctors must 'opt in' to provide abortion services
The NAGP passed a series of motions after an emergency meeting today following the result of the referendum.

June 9, 2018

THE NATIONAL ASSOCIATION of General Practitioners (NAGP) have held an emergency meeting to discuss the outcome of the Eighth Amendment referendum, and passed motions calling for an “opt-in” provision for doctors to provide abortion services.

The NAGP have also called for a conscientious objection provision to be inserted into any legislation passed by government in the wake of the referendum result.

When the Colombian Constitutional Court partially decriminalized abortion in 2006, the Court established a right to abortion in three circumstances: when the life or health (including mental well-being) of the mother is at risk; when a fetal anomaly is incompatible with life; and when the pregnancy is the result of rape, incest or forced insemination. The Court also outlined guidelines for health care providers who wish to invoke conscientious objection. Individuals can object, but institutions cannot; objecting physicians have a duty to refer patients to another provider; and conscientious objection “may not involve disregard for the rights of women.” Nevertheless, improperly exercised conscientious objection is not uncommon in Colombia, leading many women to seek clandestine abortions, which are often unsafe. The authors conducted in-depth interviews with 13 key informants and 15 Colombian physicians who self-identified as conscientious objectors to better understand how conscientious objection is exercised.

On the basis of these interviews, the study finds that objection falls along a spectrum; it identifies three types of objectors, according to a set of characteristics shared among them. Extreme objectors believe it is their medical, ethical and religious duty to refuse to perform abortions and to prevent their patients from having an abortion. To that end, they try to change their patients’ minds, provide misleading legal and medical information, and refuse to refer their patients.

Moderate objectors tend to be religious, but are more tolerant of other perspectives; they do not seek to actively stop their patients from having abortions and do provide referrals. They also tend to be strong advocates for birth control, including emergency contraception, which they view as preventing abortions. They are generally informed by medical ethics and a commitment to “protect life,” including that of the fetus.

Partial objectors fall into two subcategories: They object either on the basis of gestational age or on a case-by-case basis. Those whose objection is based on gestational age are not motivated by religion and do not consider themselves opponents of abortion. Many are concerned about performing abortions on potentially viable fetuses, although some refuse to perform abortions even early in gestation, citing other concerns. More research is needed on the motivations of case-by-case objectors; one physician interview and comments by key informants suggest that this kind of partial objection is not unusual.

The researchers urge that in order to develop effective interventions to reduce improper use of conscientious objection as a barrier to safe and legal abortion, objectors should not be treated as a homogenous group. Instead, interventions should be tailored to target different types of objectors. For example, dialogues on the value of referral between moderate and extreme objectors who share religious beliefs could help some extreme objectors move toward offering referrals so that their patients do not seek clandestine—and potentially unsafe—abortions. The authors also recommend that continuing medical education and medical school curricula be revised to broaden the bioethical perspective on abortion and reflect the decriminalization of abortion. Furthermore, all physicians, regardless of their objector status, would benefit from values clarification exercises and training about the health exception in the abortion law. Finally, the researchers suggest that the limited nature of the decriminalization of abortion in Colombia allows conscientious objectors to act as gatekeepers and mislead women about their rights. Expanding the country’s abortion law to allow abortion on request, they say, would maintain objectors’ rights while reducing their ability to act as barriers to safe, legal abortion care.